Instant Genius - How to lose weight the scientific way

Episode Date: January 26, 2024

Chances are, many of us will have tried to drop a few pounds at some point in our lives. And it’s likely that to do so we will have cut down on the amount of calories we are consuming, exercised a bit more and relied on willpower to stop ourselves reaching for the biscuit tin, bag of crisps or can of fizzy drink. But is there a more effective method? In this episode we catch up with Dr Andrew Jenkinson, a bariatric surgeon based at University College London Hospital and author of the book How to Eat Well (And Still Lose Weight). He tells us how our brains are hard-wired to crave salty, fatty, sugary foods and how gaining a better understanding of our biology can help us to turn our unhealthy eating patterns into healthy ones, for good. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Hello and welcome to Instant Genius, a bite-sized masterclass in podcast or. Each week you'll hear world-leading scientists and experts talking about the most fascinating ideas in science and technology today. I am Jason Goodyear, commissioning editor at BBC Science Focus magazine. Chances are many of us will have tried to drop a few pounds at some point in our lives, and it's likely that to do so we will have cut down on the amount of calories we're in consuming, exercised a bit more, and relied on willpower to stop ourselves reaching for the biscuit tin, bag of crisps or can of fizzy drink.

But is there a more effective method? In this episode we catch up with Dr Andrew Jenkinson, a bariatric surgeon based at University of College London Hospital, an author of the book How to Eat Well and Still Lose Weight. He tells us how our brains are hardwired to crave salty, fatty, sugary foods and how gaining a better understanding of our biology can help us turn out of our body. unhealthy eating patterns into healthy ones for good. Before we get started talking about the book, it sounds from reading it that you wear quite a few hats.

So I think first off, it would be nice if you were able to tell our listeners about your background and what it is you actually do. So my sort of main hat, Jason, is I'm a surgeon. I specialize in surgery for the stomach called bladder, hernias and acid reflux. But quite a lot of my work is for weight loss. So it's called bariatric surgery. So I do operations that either bypass or remove quite a lot of the stomach to help people reset their weights. And actually, the surgery, it's really, really helpful for people.

It's life-changing. You know, they'll lose 40, 50 kilograms and basically have a new life. And these people have usually been dieting for decades on end and they just can't do it with supposed willpower and whatever. The reason that the book was inspired was actually because I got into this area of surgery. and I was seeing so many patients and thinking, why would you want me to remove your stomach? Why can't you just go to the gym and go on a diet like all the nutritionists tell you? But it's not that easy.

And when you look into it and we'll come into this sort of a little bit later, it's not about a calorie. It's about what the food does to you as a drug, which we will come on to. So that's my sort of main job. And then I got into obviously writing and being an author. I also do a little bit of work abroad in the UAE now and again, medical, yeah. So quite a few jobs.

and keep it interested and varied. So you mentioned there the bariatric surgery. And I think in the UK at the moment, and as it is in most parts of the world, most people are talking about the overwhelming number of people that are overweight or obese. So how big a problem is that? I think it's a massive problem in the Western world that's going to probably contribute to bankrupting the healthcare systems. So we've got in America, a third of people are morbidly obese. That's obese to a level that's affecting their health in Europe, tends to be around about a quarter. Massive proportions of these people have type 2 diabetes, blood pressure, sleep apnea, joint problems, there's increased risk of cancer with obesity. So these

things all cost a lot of money. For the first time ever, we're seeing life expectancy decrease because of obesity. And we've got new treatments on board, so the injection treatment. But these treatments are massively expensive if you roll them out to millions and millions and millions of people, and those people then just become dependent on them. So obesity is a massive economic and health problem. that needs to be addressed. But the first thing it needs to be is understood, which is where, so of my first book, Why We Eat Too Much, and then this follow-up book, How to Eat and Still Lose Weight, come in. Obesity is not caused because there certainly is a lot of tasty, high-calorie food available to a population. It comes about because that food acts in a way that

is similar to a drug which blocks our normal weight regulation pathways. And these weight regulation pathways can be seen, you know, wild animals have very similar pathways. We don't certainly see, for instance, a prided lions becoming morbidly obese and fat and not being able to move around because suddenly there's too many antelope to eat. It doesn't happen. So in the wild, we can see populations of different animals do not suddenly become obese and unwell. So it's something in the food that causes this, and the book highlights these sort of drug-like interactions between food and our bodies and actually also our minds. So moving on from that, in the book you mentioned the huge influence of hormones

on somebody's body weight, and in particular you say leptin is the master controller of our weight. So first off, what is leptin? And how does that work? So leptin is a hormone that a lot of doctors and medical students are not that familiar with. They may remember years ago having an hour lecture on it, but actually it's profoundly important to this healthcare crisis,

economic crisis that we're running into now. Leptin is a hormone that works in the world to regulate wild animals' weights and should work in humans in the same way. It's a hormone that comes from our fat cells and the fatter we get, the more leptin we get. The level of leptin acts like a signal to our weight control center in our brain, a little area called the hypothalamus, which is in actual ultimate control of where our weight is. It affects our appetite and our metabolism. When we eat particular types of food, that food can sometimes have the effect of blocking the leptin signal. So it blocks our normal weight loss signal. Particularly, I mean, we all know that sugar and refined carbohydrates, so processed foods cause obesity.

But we sort of think it's because they've got too many calories and they're too tasty. It's not. It's because they put up our level of insulin and insulin blocks leptin. Once you lose control of leptin, your brain can no longer gauge how fat or thin you are. The analogy in the book is a little bit like when you're riding and your car up the motorway. And you see that the fuel gauge is on empty. So you sort of panic and want to pull in and go to the petrol station. But when you fill up, you realize the tank's already full.

You know, the problem is the petrol gauge meter is broken. And this is what happens in leptium resistance. So you are clearly overweight, visibly overweight, but your brain can't see that. It actually is sending you opposite signals of you're fading away. You know, the tank is empty. Abbas is so massively misunderstood by healthcare professionals. It's pretty simple. Leptin resistance is a signaling failure that causes the opposite signals to occur in a hypothalamus that should occur.

So this is why, actually, you know, a lot of my patients who are really seriously overweight will admit to me that they binge eat in private. It's embarrassing for someone who's 25 stone to be, you know, in McDonald's or whatever, just gorging themselves. But the signal they get from their leptin is that their tank is empty. So they will get an absolutely voracious appetite and need to eat. Because even they don't understand the condition, they get a very low self-esteem and think, you know, they're greedy and everything that everyone else says about them is true. So it's actually quite a heartbreaking condition that is very misunderstood and very visible.

So another sort of topic you bring up is a person's weight set point. So I personally never heard of that before. So what is it and what can affect it? So, yeah, the first book sort of introduced this to the weight set points. sometimes we call it the weight anchor. If you imagine you're like a ship and you're attached to an anchor and the anchors sort of down, you can't really sail away from that area. And it's the same with your weight anchor.

So your weight anchor might be set to the overweight or even obese category. You can try and sail away from it by thrashing yourself in the gym or going on low-calorie diets. But your weight control center and your brain will pull you back to where it wants you to be. And this is your weight set point. And it's determined by a number of things that you can. can change, but actually also one thing that you can't change, so your genes, we all know of people who are naturally slim and can eat whatever junk they want and they don't seem to put on weight, so they're lucky. But actually, a quarter to a third of the population have genes

where they have a propensity to put on weight if they're exposed to the Western diet and the Western sort of snacking and stress environment. So it's a combination of your genes, but also the weight gain genes are triggered by environment. So the absence of fresh food and the availability of sugar, refined carbohydrates, processed foods, we can go on to the other things that cause weight gain triggers, fructose and vegetable oils. All these things are just there in the Western diet. We go to a supermarket. Everything's got them in apart from the vegetable section. So if you happen to live in the environment where you get your food from a supermarket, which is where most people do in the Western world these days, you're at a real disadvantage, particularly if you have this

sort of smoke screen, not a deliberate thing, but just a misunderstanding from doctors and nutrition they're saying you've got to count your calories. It's a load of rubbish. It's all about what the food does to you as a drug. Ambition comes in all shapes and sizes. At First Citizens Bank, we roll with your goals because we're built for what you're building. Fit for your ambition for Citizens Bank. It's peak pollination season and my business is scaling fast. To keep the nectar flowing, I need a phone plan with top priority data speeds. That's why I chose GoogleFi wireless. My connections stay strong even when the hive is buzzing. Plus, unlimited plans started $35 a month. Now, that's a deal that doesn't stay. Explore Google Fi Wireless plans today. Plus taxes and government

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systems that deliver exceptional sound and unforgettable listening experiences at home. Try it for yourself at a focal powered by name boutique. Visit focal powered by name.com for more information. Okay, so you mentioned there a couple of times processed food. There's a lot of discussion about processed food in the media in general at the moment, but what exactly are they? I mean, there's a fantastic development actually recently that actually defines processed foods for the first time. This came around 15 years ago from Brazil who were really ahead of us as far as these definitions and actually their public health on food. We know pretty much all food is processed in some way unless it's literally some fruit literally just picked from a tree. There's sort of old-fashioned processing like pickling and salting and things like this to preserve foods.

And there's cooking, which is a type of processing to make food more eatable. more chewable. But ultra-processed foods are a different thing. This is a category of food, not your traditional processing, but something that's come in over the last 30 or 40 years, where food is engineered. So, for instance, foods that may have helped contribute to cooking a recipe such as sugar or flour become the main ingredient of processed food, a manufactured food. And these foods are designed by food scientists. Because they're extremely bland naturally, they have colourings and flavourings and obviously amulsifiers and things that make them sort of crunch and taste good in the mouth. So these are engineered foods to really light up our reward pathways in our brains.

Obviously we go back quite a few hundred thousand years as humans to the origins of Homo sapiens from Homo erectus. And we have quite vulnerable brains as far as food is concerned. We love food that is bright and sweet and it's got a lot of calories. those foods really light up our dopamine reward pathways and we then seek signals for that food in the future. So we're constantly on the lookout for this reward. Food companies, not in a cynical way, but just in a way to increase profits compared to another company, understand our vulnerable human brain. They understand that if the engineer a food that is bright, sugary, colorful and feels good in their mouth, and it has a colorful wrapper, so we were reminded of it when we see it or when it's advertised.

they have the ideal product. It trumps natural foods. It tastes better than a natural food. It looks better than natural foods. But unfortunately, it acts like a drug. So it will have a massive propensity of sugar, refined carbohydrates, no, fructose, flavorings, and usually vegetables, all of these things really interfere with that weight control hormone, leptin. And from having, you know, a very natural self-regulation of our weight, just like, you know, we don't have to worry about how much water we drink, you know, self-regulated, from having that natural regulation, suddenly it's out of control because we're eating the wrong foods. So this is why a lot of us tend to crave these foods, even though we know that they're no good for us. Yeah. So all of us do. I mean, one of the premises

of the book is if you really understand what this type of food does to you, not only from a physical, you know, hormonal point of view, switching off your weight regulation pathways, if you don't suffer with abuse, it can cause inflammatory conditions, you know, Western diseases to the asthma allergies, exoma, things like that, fibromyalgia. If you start to understand what these types of foods do to your body, but then also understand how the food environment works as far as your cravings, your habits, these actions you've done repetitively, you know how many times you've had at McDonald's or whatever,

we know the process. You're going to see the advert, you're going to crave it, you're going to go there, it's going to be all too easy to order it. It's going to taste great, maybe not an hour later, but when you're eating it, it's going to taste fantastic. But these actions are carved into our brain and become almost habitual, subconscious things for some people who eat these things regularly. If we understand all of this, then we are almost changing our personality. By understanding, we get it.

It's then much easier to change towards healthier foods without using willpower. It's like, no, I understand it, I get it. I don't want to eat that anymore. It's not I'm using willpower, I'm going to give up McDonald's. It's a totally new way of thinking and trying to change your habits and the type of foods that you eat in order to over the long term improve your health, not just for weight loss, but also for these inflammatory diseases. And that's the sort of premise of the book. Understand what food does you, what processed food does you in a bad way, what healthy foods do you in a really good way, phytochemicals, antioxidants, these things that fight inflammatory disease make you live longer. All of these things, once you get it, you'll start to crave that type of food.

you won't be craving a McDonald's anymore. And the back of the book has got some really sort of tasty, it's cool global kitchen, so like some recipes from around the world, which some of them will substitute things like rice for buckwheats. They tend to have really great omega-3 to six profiles. We haven't sort of discussed that yet, but that's something that is like an antidotes of vegetable oils and inflammation. So you've mentioned a couple of times here, calories and the misconception that surrounds them

when it comes to this sort of thing. So first off, what are we actually talking about when we've done? talk about a calorie and what's their role in this in the wider picture? But we need calories to live. So a calorie is a unit of energy, it's stored in plants. Plants store carbohydrates and energy in the cellular matrix. And whether it's processed foods that's been derived from plants originally or whether it's fresh plant food or animals that have eaten the plant, they contain these carbon bonds that when broken, release energy. And we use that energy to live to heat our bodies, heartbeat, move around.

The interesting thing is that 70% of the energy that uses humans is even before we move. So this is called our basal metabolism. And it basically just runs our immune system, as I said before, heating, breathing, heart rate. The thing that's slightly misunderstood by people who are totally focused on calories is the body can get rid of calories very easily. It can switch up our basal metabolism by six or seven hundred kilo calories per day. This is the same as a 10K run or a large three-course meal. or it can switch it down. It's almost like we have this metabolism that's like an inner dimmer switch that can be turned up bright or it can be turned down. If we go on a low calorie

diet, we easily, within a couple of weeks, adapt to low calories by switching our metabolism down, suddenly weight loss stops. Most of us actually overeat when you look at the amount of calories will we consume. And we should be putting on a hell of a lot more weight than we are. But actually, our buddies are trying to fight that by increasing our metabolisms, which is actually why we have a bit of a Western epidemic of high blood pressure and things like that. It's a way of the body increasing our basal metabolism by increasing heart rates and blood pressure, just expending more energy via this thing called the sympathetic nervous system. The crux of it is, Jason, but calories obviously we need from food to survive, but we can't really manipulate them to manipulate our

weight down or up. Our brains are in control and it will just say, okay, we've got low calorie diet coming or in a famine situation, we're just going to turn down that dimmer switch and not burn as much off. And then obviously you get these other hormones that make you really want to go and eat and seek high calorie foods when you're on a diet. So another thing that people will often say, I think you touched on it earlier, if you do want to lose weight, you have to do two things. You have to eat fewer calories and move more. So what role does exercise have to play in all of this? If you can afford to go to the gym for an hour and a half, six days a week, and to very vigorous activity during that time. So we're talking about expending maybe a thousand calories a day

on exercise. This is like things that you can't do unless you're an athlete because you're probably going to get injured anyway if you do that much activity. That can have an effect in the long term on your weight. But most people, the recommendation of half an hour, three or four times a week, isn't going to have any significant effect on your weight, maybe two kilograms in a whole year. Just like, as I said before, our metabolism will become more efficient if we go on a diet and calorie restrict. It also becomes more efficient if we use a lot of energy up in the gym. If we go to the gym and do a half hour or 40 minute run and we expend 400 kilocalaries, for instance, one we're going to get actually quite hungry and probably unless we have an iron will consume those 400 calories.

And if we don't, if we do have the iron will, actually we're just going to burn 400 less when we sleep. So the body's in control and metabolism's in control. The way of tramping it is to do both calorie restriction and vigorous activity, double whammy. Metabolisms can't readjust more than about 6 or 700 kilocalories per day. So if you manipulate it to over 1,000, you will start to lose weight. It's extremely difficult, though. You know, you're going to be absolutely shattered and hungry. So it's often said that most attempts to lose weight by dieting fail.

And this is something that we've sort of touched on there. What's your opinion on that? It's not about dieting. It's about diet. Okay. If you understand what various different foods do to your body as a drug, as it were, and you avoid those foods, you will lose weight. If you avoid sugar and highly refined carbohydrate, if you avoid fructose, which is a separate area of weight gain, and if you avoid vegetable oils, which again have detrimental effects on insulin, if you switch from those types of food,

which tends to be processed food, towards less processed foods, home-prepared foods, you don't have to be hungry, you don't have to be irritable, you do have to use some time shopping and cooking, which actually, once you get into it, it's quite meditative and should improve stress levels. If you just change your lifestyle away from fast foods and processed foods and convenience foods towards a more old-fashioned way of eating, without any effort your weights, that point your weight anchor will shift downwards and you'll lose a decent amount of weight, much more weight than if you went to the gym regularly. So we've covered an awful lot there, but as a sort of summing up question, Say somebody's listening and they want to lose a bit of weight.

Other than buying your book, how should they make a start? I think once you understand how habits form good habits and bad habits, it's just understanding, you know, what triggers sometimes the start of a bad habit. Maybe other people are like this. Maybe they eat mindlessly a little bit in the evening over whatever is on Netflix or Prime. What triggers that? Why do you need to eat that type of food? Why don't you replace that type of food with, for instance, a vegetable, charcutree board,

you know, chop up a load of fresh vegetables. They're fantastic for you, sprinkle a little bit of salt on. Have that instead of toxic foods. So it's all a little bit about identifying bad habits and trying to slowly change them into better habits. When we give something up, we're all going to crave that food, for instance, sugar or chocolate or whatever. A good method of trying to fight that crave is to actually become aware of the crave, go what I call crave surfing. So you become very aware of the intensity of the crave, that feeling of wanting something,

and it will crescendo, it will go up and up and up and become more intense, and you'll realize, oh, okay, it's going down again now. It will come in a few waves, but every wave will be shallower. Rather than trying to ignore the crave, actually concentrate on it and realize that you've gone through it, it's okay. And the third thing you can do is a lot of people eat because there's stressed, processed and sugary foods are like a drug to us. It's the same as a cigarette or a glass of wine, you know, gives us a good feeling.

If you can somehow control your sort of internal stresses without resorting to drugs, including food, you're much more likely to succeed in getting along a path towards much healthier foods. And there's the de-stress toolkit there in the book. There's different things. There's some really, really interesting breathing techniques. We know they work. It's explained how they work. They really do work.

You can control how you feel via breathing. Different types of meditation is a particular one, which is actually you don't have to try and relax for anything. you just become very aware of your surroundings and don't do anything else. And things like visualization. Once practiced, you may find one or two of them are really helpful for you. They really can help you just relax. And then you don't have to resort to drugs in the form of processed foods. Thank you for listening to this episode of Instant Genius, brought to you from the team behind BBC Science Focus.

That was Dr. Andrew Jenkinson. The current issue of BBC Science Focus magazine is out now. Pick up a copy wherever you buy your favourite magazines. or download us on your preferred app store. You can also find us online at sciencefocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal.

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